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The decision of when to start prostate cancer screening and how often to screen should be made on an individual basis, taking into account a man’s age, risk factors, and personal preferences, as well as guidance from healthcare providers. Here are some general recommendations for prostate cancer screening:
- Age 50 for average-risk men: For men at average risk of prostate cancer, the American Cancer Society (ACS) recommends starting discussions about prostate cancer screening with healthcare providers at age 50. Screening may include a digital rectal examination (DRE) and a prostate-specific antigen (PSA) blood test.
- Age 45 for men at higher risk: Men at higher risk of prostate cancer, such as African American men and men with a family history of prostate cancer (father, brother), may be advised to start discussions about prostate cancer screening at age 45.
- Age 40 for men at very high risk: Men at very high risk of prostate cancer, such as those with multiple first-degree relatives (father, brother) diagnosed with prostate cancer at a young age (before age 65), may be advised to consider starting discussions about prostate cancer screening at age 40.
- Shared decision-making: The decision to undergo prostate cancer screening should be made through shared decision-making between the individual and their healthcare provider. This process involves discussing the potential benefits and risks of screening, considering individual preferences and values, and making an informed decision based on the best available evidence.
- Frequency of screening: The frequency of prostate cancer screening may vary depending on individual risk factors, preferences, and screening results. In general, for men who choose to undergo screening and have normal results, screening may be repeated every 1 to 2 years.
It’s important to note that prostate cancer screening is not without controversy, and the benefits and risks of screening should be carefully considered. Screening may lead to the detection and treatment of prostate cancers that may never cause symptoms or harm during a man’s lifetime (overdiagnosis and overtreatment). Additionally, false-positive results may lead to unnecessary anxiety and follow-up testing, while false-negative results may provide false reassurance.
Men should discuss the benefits and risks of prostate cancer screening with their healthcare provider and make an informed decision based on their individual circumstances. Regular discussions with healthcare providers about prostate cancer screening are important for early detection and management of the disease.